Jan
Prasko, Jiri Horacek, Jan Klaschka, Jirina
Kosova,
Ivana Ondrackova & Jiri Sipek
Head
of the Psychiatric Centre Prague: Prof. MUDr. Cyril Höschl,
DrSc.
Psychiatric centre Prague, Ustavni 91, Prague - 8, 181 03
Czech Republic
3rd Medical faculty Charles University Prague, Centre of Neuropsychiatric
Studies
Submitted:
January 19, 2002
Accepted: January 23, 2002
Key
words:
Major depressive disorder, inpatients, bright light therapy,
imipramine, combination, clinical trial
Abstract
INTRODUCTION:
The aim of a double-blind study was to assess the efficacy
of bright light therapy and/or imipramine in the treatment
of inpatients suffering with recurrent non-seasonal major
depressive disorder.
METHOD:
34 in-patients with DSM-III-R diagnosis of major depressive
disorder, recurrent type, were randomly allocated into 3 treatment
groups. After 4-day washout period with baseline assessment
they underwent 3 weeks of different types of treatment:
a) Group A: bright light therapy (5000 lux from 6-8 a.m.)
and imipramine 150 mg/day.
b) Group B: bright light therapy (5000 lux from 6-8 a.m.)
and imipramine-like placebo.
c) Group C: dim red light (500 lux from 6-8 a.m.) and imipramine
150 mg/day.
Outcome measures included weekly Hamilton Psychiatric Rating
Scale for Depression, Clinical Global Impression Scale, Montgomery
and Asberg Psychiatric Rating Scale for Depression and Beck
Depression Inventory.
RESULTS:
Patients of all three groups improved significantly. The improvement
of the patients of group B treated with bright light therapy
plus placebo was superior to the other two groups, but not
significantly.
CONCLUSION:
Bright light therapy can be effective in the treatment of
non-seasonal major depressive disorder.
Introduction
Depression
is a common disorder, with serious consequences for a high
proportion of patients. Indeed, it is estimated that 2.6 -
6.2% of the general population experience depression in any
given year [1] and that 15% of those who develop severe and
recurrent illness eventually take their own lives [2]. Unfortunately,
although ranges of effective antidepressant agents are available,
many require an administration period of at least 2 weeks,
and some up to 4 weeks, before a therapeutic effect is seen
[3]. Bright light is a unique treatment method, which is effective
and well tolerated and has an early onset of action, in the
treatment of patients with Seasonal affective disorder [4,
5]. Some studies reported an antidepressant effect of bright
light also in non-seasonal depression (non-SAD) [6, 7, 8].
However, the reports concerning the effect of a short-term
administration of bright light on non-SAD depression are controversial.
The aim of our double-blind study was to compare the effect
of a three week bright light therapy and/or imipramine in
the treatment of inpatients suffering with recurrent non-seasonal
major depressive disorder.
Subject
and Methods
The inclusion criteria ... ...
Exclusion criteria: ... ...
Light specifications: ... ...
Main outcome measures: ... ...
Statistical analysis: ... ...
Results
... ...
Discussion
... ...
Acknowledgement
Supported
by grant CNS LN00B12 MSMT CR and by grant IGA: 870-2.
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